Sardanelli F, Imperiale A, Zandrino F, Calabrese M, Bonifacio A, Canavese G, Nicolo G
Department of Radiology, University of Genoa, San Martino Hospital, Italy.
Radiology. 1997 Jul;204(1):143-8. doi: 10.1148/radiology.204.1.9205236.
To evaluate ultrasonographic (US)-guided fine-needle aspiration (FNA) of intraductal masses performed immediately after galactography and to compare cytologic findings from US-guided FNA with those from nipple discharge.
In 36 patients with nipple discharge from a single duct in one breast and intraductal masses diagnosed at galactography, US was performed to detect intraductal lesions and perform FNA before removal of the galactographic catheter. Cytologic analysis of nipple discharge, excisional biopsy, and histopathologic evaluation were performed in all patients.
Cytologic analysis revealed 23 nonpapillary benignancies, seven papillomas, five indeterminate cases, and one carcinoma. US-guided FNA cytologic analysis revealed 16 papillomas, 10 nonpapillary benignancies, five indeterminate cases, and three carcinomas. The two carcinomas misdiagnosed as papillomas at US-guided FNA cytologic analysis were papillary in situ carcinomas, while the three carcinomas correctly identified were invasive (only one was detected with cytologic analysis of nipple discharge). With cytologic analysis of nipple discharge, nine (25%) of 36 diagnoses were correct, and with US-guided FNA, 18 (50%) were correct (P = .0352).
Compared with cytologic analysis of nipple discharge, US-guided FNA cytologic analysis seems to add useful information for tailored surgical planning.
评估在乳腺导管造影后立即进行的超声（US）引导下导管内肿块细针穿刺抽吸（FNA），并比较US引导下FNA的细胞学检查结果与乳头溢液的细胞学检查结果。
对36例单乳单导管乳头溢液且乳腺导管造影诊断为导管内肿块的患者，在移除乳腺导管造影导管前，进行US检查以检测导管内病变并进行FNA。所有患者均进行了乳头溢液的细胞学分析、切除活检和组织病理学评估。
细胞学分析显示23例非乳头状良性病变、7例乳头状瘤、5例不确定病例和1例癌。US引导下FNA细胞学分析显示16例乳头状瘤、10例非乳头状良性病变、5例不确定病例和3例癌。在US引导下FNA细胞学分析中被误诊为乳头状瘤的2例癌为原位乳头状癌，而正确识别的3例癌为浸润性癌（仅1例通过乳头溢液的细胞学分析检测到）。乳头溢液的细胞学分析中，36例诊断中有9例（25%）正确，而US引导下FNA为18例（50%）正确（P = 0.0352）。
与乳头溢液的细胞学分析相比，US引导下FNA细胞学分析似乎为定制手术规划增加了有用信息。
